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Neri S, Signorelli SS, Mondati E,Pulvirenti D, Campanile E, Di Pino L, Scuderi M,Giustolisi N, Di Prima P, Mauceri B, Abate G, Cilio D,Misseri M, Scuderi R (University of Catania, Catania,Italy). Ultrasound imaging in diagnosis of superiormesenteric artery syndrome. J Intern Med 2005;257: 346–351.Objectives. We screened a cohort of subjects affectedby various degree of dyspepsia to reveal if theypresented a reduction of the aorto-mesenteric angleand to diagnose suspected cases of superiormesenteric artery (SMA) syndrome.Design. Controlled, prospective, study.Setting. Subjects were studied as outpatients.Subjects. The study investigated a total of 3622subjects referred to our department by their generalpractitioners for dyspepsia and/or abdominal pain.Interventions. Abdominal ultrasonography withpower colour Doppler, gastroduodenoscopy, hypo-tonic duodenography, contrast-enhanced spiralcomputerized tomography were performed.Main outcome measurement and results. ColorDoppler revealed a significant reduction of the SMAangle in 29 of 950 subjects; gastroscopy showedduodenal compressive pulsation in 14 of 29 patientsand X-ray revealed compression of the third segmentof the duodenum in 28 of 29 patients. CT confirmedthe presence of a reduced angle and various degreesof duodenal compression in all patients. Ultra-sonography and CT examinations gave overlappingresults (P > 0.05) in diagnosing pathological aorto-mesenteric angle.Conclusion. The authors believe that the incidenceof reduced aorto-mesenteric angle and SMAsyndrome might be underrated. Ultrasoundpower colour Doppler imaging is useful inepidemiological screening of reduced aorto-mesenteric angle to diagnose suspected cases ofSMA syndrome.Keywords: abdominal pain, aorto-mesenteric angle,superior mesenteric artery syndrome, ultrasound.

We screened a cohort of subjects affected by various degree of dyspepsia to reveal if they presented a reduction of the aorto-mesenteric angle and to diagnose suspected cases of superior mesenteric artery (SMA) syndrome.Controlled, prospective, study.Subjects were studied as outpatients.The study investigated a total of 3622 subjects referred to our department by their general practitioners for dyspepsia and/or abdominal pain. Interventions. Abdominal ultrasonography with power colour Doppler, gastroduodenoscopy, hypotonic duodenography, contrast-enhanced spiral computerized tomography were performed. MAIN OUTCOME MEASUREMENT AND RESULTS: Color Doppler revealed a significant reduction of the SMA angle in 29 of 950 subjects; gastroscopy showed duodenal compressive pulsation in 14 of 29 patients and X-ray revealed compression of the third segment of the duodenum in 28 of 29 patients. CT confirmed the presence of a reduced angle and various degrees of duodenal compression in all patients. Ultrasonography and CT examinations gave overlapping results (P0.05) in diagnosing pathological aorto-mesenteric angle.The authors believe that the incidence of reduced aorto-mesenteric angle and SMA syndrome might be underrated. Ultrasound power colour Doppler imaging is useful in epidemiological screening of reduced aorto-mesenteric angle to diagnose suspected cases of SMA syndrome.